Childhood acute lymphoblastic leukaemia and indicators of early immune stimulation: the Estelle study (SFCE).
Childhood acute lymphoblastic leukaemia and indicators of early immune stimulation: the Estelle study (SFCE).
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DOI：
10.1038/bjc.2015.53
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发表时间：
2015-03-17
影响因子：
8.8
通讯作者：
Clavel, J.
中科院分区：
文献类型：
--
作者：
Ajrouche, R.;Rudant, J.;Orsi, L.;Petit, A.;Baruchel, A.;Lambilliotte, A.;Gambart, M.;Michel, G.;Bertrand, Y.;Ducassou, S.;Gandemer, V.;Paillard, C.;Saumet, L.;Blin, N.;Hemon, D.;Clavel, J.
与免疫系统早期刺激相关的因素（母乳喂养，接触传染性病原体的代理人，正常分娩，以及在生命早期接触动物）已被认为可以降低儿童急性淋巴细胞白血病（ALL）的风险。2010-2011年在法国开展了基于国家登记的病例对照研究ESTELLE。人群对照与病例的年龄和性别频率匹配。参与率为93%的病例和86%的对照。数据来自母亲的结构化电话问卷调查。采用校正年龄、性别和潜在混杂因素的无条件回归模型估计比值比（OR）。总共纳入了617例ALL和1225例年龄在1岁以下的对照。急性淋巴细胞白血病与早期常见感染之间的负相关（OR=0.8，95%置信区间（CI）：0.6，1.0），非头胎（0.33 vs 1; OR=0.7，95% CI：0.5，1.0），1岁以前上过日托中心婴儿期经常接触宠物（OR = 0.8，95%CI：0.7，1.0）、母乳喂养（OR = 0.8，95%CI：0.7，1.0）。结果支持这一假设，即促进婴儿期免疫系统成熟的条件对ALL具有保护作用。
Factors related to early stimulation of the immune system (breastfeeding, proxies for exposure to infectious agents, normal delivery, and exposure to animals in early life) have been suggested to decrease the risk of childhood acute lymphoblastic leukaemia (ALL). The national registry-based case–control study, ESTELLE, was carried out in France in 2010–2011. Population controls were frequency matched with cases on age and gender. The participation rates were 93% for cases and 86% for controls. Data were obtained from structured telephone questionnaires administered to mothers. Odds ratios (OR) were estimated using unconditional regression models adjusted for age, gender, and potential confounders. In all, 617 ALL and 1225 controls aged ⩾1 year were included. Inverse associations between ALL and early common infections (OR=0.8, 95% confidence interval (CI): 0.6, 1.0), non-first born (⩾3 vs 1; OR=0.7, 95% CI: 0.5, 1.0), attendance of a day-care centre before age 1 year (OR=0.7, 95% CI: 0.5, 1.0), breastfeeding (OR=0.8, 95% CI: 0.7, 1.0), and regular contact with pets (OR=0.8, 95% CI: 0.7, 1.0) in infancy were observed. The results support the hypothesis that conditions promoting the maturation of the immune system in infancy have a protective role with respect to ALL.
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